7 Psychological causes of ED (Erectile dysfunction)

Pedestalling. I remember working with a guy who was describing his partner. “She’s a goddess, she’s an angel’s” he said, as he raised his hands and looked up as if worshiping. Pedestalling is when a man puts his partner on a psychological pedestal, above him in some way. In so doing he is making himself less by comparison, inferior. Feelings of inferiority are generally bad for male sexual functioning.

Intimidating partner. This is like pedestalling in that it creates feelings of inferiority, the difference is that it is based on something quantifiable. Although the intimidation could be based on the partner’s higher social status, education or wealth the one I find that causes most men problems is if their partner has a greater wealth of sexual experience than they do. This one is especially problematic because the guy may question how he compares to those previous experiences, usually suspecting that he is deficient in some way (smaller penis, less stamina, too conservative etc). Once the thought occurs the guy is now focused upon his deficiencies rather than the great time he’s about to have.

Guilt, Shame. A guy I worked with many years ago always sticks in my mind. On his second marriage he was off at a work’s event and the colleague he’d been flirting with for the last few months comes up to him with a couple of drinks in her, she whispers in his ear what she wanted him to do to her that night… and his cock shrivels up to nothing. As much as he had been enjoying the flirtation, that is all it was to him flirtation. Once the reality hit him, the fear of the guilt that would be caused by cheating on his wife, fed by the guilt from cheating on his first wife, caused a strong defensive reaction in his body. Sadly, this carried over into his marital relations. By no means a typical example, most guys get the guilt and shame when trying to have sex with the partner they are cheating on, but the principle stands. Affairs cause guilt, guilt inhibits enjoyment, which present as ED with the official partner.

Relationship problems. Beyond the specifics of cheating, wider relationship problems can cause tension in the bedroom, which translates into ED. This can lead to one or both partners not being excited by sex. As such they may carrying negative emotions into the bedroom. This distracts and inhibits excitement. If the guy is not excited, then arousal for erection may be difficult to achieve. If the partner is not excited, the guy may become aware of this and feel unpleasant, thus inhibiting erection. Even with couples who have a history of ‘make up sex’ the problems may be too big.

Poor environment for sex. Often overlooked by both guys with ED and the professionals who are there to help them is the environment in which sex can occur. If the environment is unsexy (cold, with damp issues etc) or constrained (no sex till the kids are asleep) then this can affect the mood.

Stress and Trauma. Both current life stress and personal history of trauma can induce problems. Usually these prevent the guy from being fully focused on sex, but they also mean that his sympathetic nervous system (the opposite of the para sympathetic nervous system – see the trauma-focus response above) is easily triggered. Stress or trauma don’t have to have anything to do with sex they simply prevent the guy from getting into a fully sexual situation. To give an example I once worked with a man who developed ED after being abducted by a business rival, who let him go unharmed several hours later. Trying to shake the experience off he attempts to distract himself with sex with his wife and finds he simply cannot get into it.

Stimulation failure. This happens to guy’s who are into something which isn’t present when they are having sex. The classic example would be a gay guy trying to have sex with a woman, which still occasionally happens. Other examples include guys with strong specific fetishes who are unable to access the fetish during sex. Insufficient attraction to the partner is rare but can occur in arranged marriages or when the physical or psychosocial attractiveness of the partner is compromised in some way.